AMN Healthcare Services Inc (AMN) 2023 Q1 法說會逐字稿

Good day, and thank you for standing by. Welcome to the AMN Healthcare First Quarter 2023 Earnings Call. (Operator Instructions) Please be advised that today's conference is being recorded.

美好的一天，謝謝你的支持。歡迎來到 AMN Healthcare 2023 年第一季度財報電話會議。 （操作員說明）請注意，今天的會議正在錄製中。

I would now like to hand the conference over to our speaker, Randle Reece, Senior Director of Investor Relations. Please go ahead.

我現在想把會議交給我們的發言人，投資者關係高級總監 Randle Reece。請繼續。

Good afternoon, everyone. Welcome to AMN Healthcare's First Quarter 2023 Earnings Call. A replay of this webcast will be available at ir.amnhealthcare.com following the conclusion of this call.

大家下午好。歡迎來到 AMN Healthcare 2023 年第一季度財報電話會議。本次電話會議結束後，將在 ir.amnhealthcare.com 上重播該網絡廣播。

Various remarks we make during this call about future expectations, projections, trends, plans, events or circumstances constitute forward-looking statements. These statements reflect the company's current beliefs based upon information currently available to it. Our actual results may differ materially from those indicated by these forward-looking statements because of various factors and cautionary statements, including those identified in our most recently filed Forms 10-K and 10-Q our earnings release and subsequent filings with the SEC.

我們在此次電話會議中就未來預期、預測、趨勢、計劃、事件或情況發表的各種評論構成前瞻性陳述。這些陳述反映了公司基於目前可用信息的當前信念。由於各種因素和警示性聲明，包括我們最近提交的 10-K 和 10-Q 表格我們的收益發布以及隨後向美國證券交易委員會提交的文件中確定的因素，我們的實際結果可能與這些前瞻性陳述所表明的結果存在重大差異。

The company does not intend to update guidance or any forward-looking statements provided today prior to its next earnings release.

公司不打算在下一次收益發布之前更新今天提供的指導或任何前瞻性陳述。

This call contains certain non-GAAP financial information.

此電話包含某些非 GAAP 財務信息。

Information regarding and reconciliations of these non-GAAP measures to the most directly comparable GAAP measures are included in our earnings release and on our financial reports page at ir.amnhealthcare.com.

關於這些非 GAAP 措施與最直接可比的 GAAP 措施的信息和對賬包含在我們的收益發布和我們在 ir.amnhealthcare.com 的財務報告頁面上。

On the call today are Cary Grace, Chief Executive Officer; Jeff Knudson, Chief Financial Officer; Landry Seedig, Group President and COO of Nursing and Allied Solutions; and James Taylor, President and COO of Physician and Leadership Solutions.

今天接聽電話的是首席執行官 Cary Grace；首席財務官 Jeff Knudson； Nursing and Allied Solutions 集團總裁兼首席運營官 Landry Seedig；以及 Physician and Leadership Solutions 總裁兼首席運營官 James Taylor。

I will now turn the call over to Cary.

我現在將把電話轉給 Cary。

Thank you, Randy, and welcome, everyone. AMN continued the strong partnership with our clients and clinicians in rebuilding a post-COVID sustainable workforce, which is evident in our solid first quarter results reported today. The industry landscape is changing, and we are moving quickly to bring clients the breadth of our solutions to help them with their workforce challenges and needs. The health care workforce landscape was shaken by the pandemic. clients emerge seeking more sustainable and controllable solutions to achieve their growth targets while balancing quality and cost. We see clients more open to change, looking at new ideas that could help them create a more sustainable workforce.

謝謝你，蘭迪，歡迎大家。 AMN 繼續與我們的客戶和臨床醫生建立強有力的合作夥伴關係，以重建 COVID 後可持續的勞動力隊伍，這在我們今天公佈的第一季度穩健業績中顯而易見。行業格局正在發生變化，我們正在迅速採取行動，為客戶提供更廣泛的解決方案，幫助他們應對勞動力挑戰和需求。大流行動搖了醫療保健勞動力格局。客戶不斷湧現，尋求更具可持續性和可控性的解決方案，以實現其增長目標，同時平衡質量和成本。我們看到客戶更願意改變，尋找可以幫助他們創造更具可持續性的員工隊伍的新想法。

Health care professionals are also in transition, focusing on control, flexibility and well-being in their work and open to new options to achieve those goals. All of this change is complicated by the continued shortage of health care professionals, which we expect to be a challenge for some time.

醫療保健專業人員也在轉型，他們在工作中註重控制、靈活性和幸福感，並對實現這些目標的新選擇持開放態度。所有這些變化都因醫療保健專業人員的持續短缺而變得複雜，我們預計這將是一段時間內的挑戰。

Our latest position in nurse surveys showed rising numbers of professionals who plan to change jobs or leave the profession. We expected a direction change in the market this year, and we are making decisive moves to operationalize our growth plans, including technology and analytics to enable more comprehensive and sustainable workforce solutions, greater client focus and enhanced speed and efficiency in bringing all our solutions together to benefit our clients and clinicians.

我們在護士調查中的最新情況顯示，越來越多的專業人員計劃換工作或離開該行業。我們預計今年市場的方向會發生變化，我們正在採取果斷行動來實施我們的增長計劃，包括技術和分析，以實現更全面和可持續的勞動力解決方案，更加關注客戶，並提高將我們所有解決方案整合在一起的速度和效率使我們的客戶和臨床醫生受益。

We said last quarter that our solution set would become even more comprehensive and differentiated and it is happening. In recent weeks, our leadership team came together to develop a 12-month plan to accelerate the evolution of our businesses, starting with Nurse and Allied.

我們在上個季度表示，我們的解決方案集將變得更加全面和差異化，而這正在發生。最近幾週，我們的領導團隊齊聚一堂，制定了一項為期 12 個月的計劃，以加速我們業務的發展，從 Nurse 和 Allied 開始。

We are moving swiftly to the implementation phase with changes that will boost our speed to deliver, provide the unified sales experience our clients desire and strengthen our value proposition. To drive further engagement with a broader pool of clinicians, we already built AMN Passport into the top rated and most powerful mobile app for nurse job search and career engagement, enabling our recruiters to grow their clinician base more effectively. AMN Passport is the only app that combines customized job search and engagement, AI job matching, credentialing self-service and time and pay.

我們正在迅速進入實施階段，這些變化將加快我們的交付速度，提供客戶期望的統一銷售體驗，並加強我們的價值主張。為了推動與更廣泛的臨床醫生的進一步接觸，我們已經將 AMN Passport 打造成為評分最高、功能最強大的護士求職和職業參與移動應用程序，使我們的招聘人員能夠更有效地擴大他們的臨床醫生基礎。 AMN Passport 是唯一一款結合了定制求職和參與、AI 職位匹配、認證自助服務以及時間和薪酬的應用程序。

We will continue to elevate Passport to be a digital staffing solution for all health care job seekers at any stage of their careers across all AMN businesses. To help our clients with workforce management, we rolled out several new features this year with more (inaudible) to ShiftWise, which we believe is the only scalable enterprise VMS platform made for health care. We have modernized the architecture of our VMS platforms using advanced cloud services and newer web and mobile technologies, bringing a fresh user-friendly interface.

我們將繼續將 Passport 提升為數字化人員配置解決方案，適用於所有 AMN 業務中處於職業生涯任何階段的所有醫療保健求職者。為了幫助我們的客戶進行勞動力管理，我們今年推出了幾項新功能，其中包括更多（聽不清）到 ShiftWise，我們認為它是唯一用於醫療保健的可擴展企業 VMS 平台。我們使用先進的雲服務和更新的網絡和移動技術對我們的 VMS 平台架構進行了現代化改造，帶來了全新的用戶友好界面。

Our data cloud for predictive and advanced analytics is powered by Snowflake and other AI technology partners. We also advanced our capabilities to integrate with our clients' HR system to drive digital and automation efficiencies. We have a strong history of flexing our cost structure to meet changes in demand. In this current demand environment, we are closely managing our resources while also sustainably scaling our cost base through platform integration and automation across AMN. We believe these efforts, coupled with a favorable revenue mix shift will sustain an adjusted EBITDA margin above 15% for the full year.

我們用於預測和高級分析的數據云由 Snowflake 和其他 AI 技術合作夥伴提供支持。我們還提高了與客戶的人力資源系統集成的能力，以推動數字和自動化效率。我們在調整成本結構以滿足需求變化方面有著悠久的歷史。在當前的需求環境中，我們正在密切管理我們的資源，同時還通過跨 AMN 的平台集成和自動化可持續地擴展我們的成本基礎。我們相信，這些努力，加上有利的收入結構轉變，將使全年調整後的 EBITDA 利潤率保持在 15% 以上。

Our priorities in capital management remain focused

我們在資本管理方面的重點仍然是重點

on disciplined growth. This year, we plan to spend approximately $90 million on capital expenditures prioritizing the key technology and operational initiatives I outlined. We are also announcing an accelerated share repurchase program given the long-term growth opportunities we see ahead. Our team remains focused on M&A opportunities as well, and we are confident in our ability to continue to use M&A to strengthen our solution set and enhance shareholder value.

關於有紀律的成長。今年，我們計劃花費大約 9000 萬美元用於資本支出，優先考慮我概述的關鍵技術和運營計劃。鑑於我們看到未來的長期增長機會，我們還宣布了一項加速的股票回購計劃。我們的團隊也仍然專注於併購機會，我們相信我們有能力繼續利用併購來加強我們的解決方案集並提高股東價值。

Finally, new leadership will bolster our accelerated transformation with 3 extremely qualified executives reporting directly to me, leading areas that empower our delivery of tech-enabled workforce solutions and our focus on client centricity and growth. Meredith Lapointe is taking a newly created role as Chief Business Officer responsible for strategy, workforce optimization, marketing and client relations. Meredith is well known for helping build the health care practice at McKinsey for the past 16 years. She knows the best workforce strategy is being implemented today and is uniquely qualified to foster strategic conversations with executives across the health care sector.

最後，新的領導層將通過 3 名非常合格的高管直接向我匯報，推動我們加速轉型，領導領域使我們能夠提供技術支持的勞動力解決方案，並專注於以客戶為中心和增長。 Meredith Lapointe 正在擔任新設立的首席商務官一職，負責戰略、勞動力優化、營銷和客戶關係。梅雷迪思因在過去 16 年幫助麥肯錫建立醫療保健實踐而聞名。她知道當今正在實施的最佳勞動力戰略，並且具有獨特的資格來促進與整個醫療保健部門的高管進行戰略對話。

Meredith was drawn to AMN by our powerful set of workforce solutions and technology the opportunity to create value in our client partnerships and the strong values and culture of our organization.

Meredith 被我們強大的勞動力解決方案和技術吸引到 AMN，在我們的客戶合作夥伴關係中創造價值的機會以及我們組織的強大價值觀和文化。

Pat McCall is coming to AMN to serve as our Chief Growth Officer. Pat's background as a senior strategic sales leader with People2.0, Randstad, Beeline and other top players already brought him recognition as one of the staffing industry's most influential leaders.

Pat McCall 將來到 AMN 擔任我們的首席增長官。 Pat 在 People2.0、Randstad、Beeline 和其他頂級公司擔任高級戰略銷售主管的背景已經使他成為人力資源行業最具影響力的領導者之一。

Pat is the ideal leader to develop and operationalize and enterprise-wide growth acceleration focused around innovative technology and services.

Pat 是專注於創新技術和服務的開發和運營以及企業範圍內加速增長的理想領導者。

Similar to our other 2 segments. Our Technology and Workforce Solutions segment will now have a dedicated leader.

類似於我們的其他 2 個細分市場。我們的技術和勞動力解決方案部門現在將有一位專門的領導者。

This important segment will be led by Nishan Sivathasan, who served most recently as our Chief Strategy and Experience Officer, including business strategy and M&A.

這一重要部分將由 Nishan Sivathasan 領導，他最近擔任我們的首席戰略和體驗官，包括業務戰略和併購。

Meredith, Pat and Nishan are the leaders we need to accelerate our progress in key client and tech-driven solutions to become essential partners enabling the future of care.

Meredith、Pat 和 Nishan 是我們需要的領導者，以加快我們在關鍵客戶和技術驅動解決方案方面的進展，成為實現未來護理的重要合作夥伴。

Now I'll turn the call over to Jeff for the details about our results and outlook, after which I will return for some final comments.

現在我將電話轉給 Jeff，了解有關我們的結果和前景的詳細信息，之後我將返回進行一些最終評論。

Thank you, Cary, and good afternoon, everyone. First quarter revenue of $1.126 billion was near the high end of our guidance range with the technology and workforce solutions and Physician and Leadership Solutions segment performing above expectations. Consolidated revenue was down 27% from the peak quarter of the pandemic last year and flat sequentially.

謝謝卡里，大家下午好。第一季度 11.26 億美元的收入接近我們指導範圍的高端，技術和勞動力解決方案以及醫師和領導力解決方案部門的表現超出預期。綜合收入比去年大流行的高峰季度下降了 27%，環比持平。

Gross margin for the quarter was 32.8%, up 80 basis points from the prior year period, mainly due to a mix shift in revenue towards higher-margin businesses. Sequentially, gross margin decreased 50 basis points primarily driven by the Nurse and Allied Solutions segment. Consolidated SG&A expenses were $206 million or 18.3% of revenue compared with $258 million or 16.6% of revenue in the prior year period and $219 million or 19.5% of revenue in the previous quarter. The decrease in SG&A expenses year-over-year was primarily due to our efforts to adjust expenses in the current demand environment, along with less variable compensation with lower revenue. Sequentially, lower credit loss expense, variable expenses and legal expenses were the primary reasons for the decrease.

本季度的毛利率為 32.8%，比去年同期增長 80 個基點，這主要是由於收入向利潤率更高的業務的混合轉變。隨後，毛利率下降了 50 個基點，這主要是受護士和聯合解決方案部門的推動。綜合 SG&A 費用為 2.06 億美元，佔收入的 18.3%，上年同期為 2.58 億美元，佔收入的 16.6%，上一季度為 2.19 億美元，佔收入的 19.5%。 SG&A 費用同比下降主要是由於我們在當前需求環境下努力調整費用，以及可變薪酬較少，收入較低。隨後，較低的信用損失費用、可變費用和法律費用是減少的主要原因。

Adjusted SG&A, excluding certain nonrecurring expenses and stock-based compensation expense was $191 million in the first quarter or 16.9% of revenue compared with $239 million or 15.4% of revenue in the prior year period. The increase in adjusted SG&A margin year-over-year was mainly driven by lower revenue offset in part by our expense management initiatives. In the first quarter, Nurse and Allied revenue was $824 million, down 33% from the record high of the prior year period and flat sequentially. Average bill rate was down 22% year-over-year and sequentially was up 3%. Year-over-year, volume was down 11%, and average hours worked were down 3%. Sequentially, both volume and average hours were flat. Travel Nurse revenue during the first quarter was $593 million, a decrease of 39% from the prior year period and up 2% versus prior quarter.

調整後的 SG&A（不包括某些非經常性費用和基於股票的補償費用）在第一季度為 1.91 億美元，佔收入的 16.9%，而去年同期為 2.39 億美元，佔收入的 15.4%。調整後的 SG&A 利潤率同比增長主要是由於收入減少部分被我們的費用管理舉措所抵消。第一季度，Nurse and Allied 收入為 8.24 億美元，較上年同期的歷史高位下降 33%，環比持平。平均票據利率同比下降 22%，環比上升 3%。與去年同期相比，數量下降了 11%，平均工作時間下降了 3%。隨後，交易量和平均小時數均持平。第一季度 Travel Nurse 收入為 5.93 億美元，比去年同期下降 39%，比上一季度增長 2%。

Allied revenue during the quarter was $196 million, down 8% year-over-year and flat with prior quarter. Nurse and Allied gross margin during the first quarter was 25.9% and down 30 basis points from the prior year period and down 70 basis points sequentially. Year-over-year, gross margin was lower, primarily due to lower average hours worked. Quarter-over-quarter, higher pay packages and less labor disruption revenue weighed on the margin comparison. Segment operating margin of 13.8% and was 210 basis points lower year-over-year due to lower operating leverage. Sequentially, operating margin increased 110 basis points primarily reflecting lower credit loss expense. Physician and Leadership Solutions revenue in the first quarter was $166 million, a decrease of 8% year-over-year and 1% sequentially.

本季度聯盟收入為 1.96 億美元，同比下降 8%，與上一季度持平。第一季度護士和聯合毛利率為 25.9%，比去年同期下降 30 個基點，環比下降 70 個基點。與去年同期相比，毛利率較低，主要是由於平均工作時間減少。與上一季度相比，更高的薪酬方案和更少的勞動力中斷收入對利潤率比較產生了壓力。由於較低的經營槓桿，該部門的經營利潤率為 13.8%，同比下降 210 個基點。隨後，營業利潤率增加了 110 個基點，主要反映了較低的信用損失費用。第一季度醫師和領導力解決方案收入為 1.66 億美元，同比下降 8%，環比下降 1%。

Locum Tenens revenue was $107 million, down 5% from the prior year or growing by 11% and excluding pandemic-related assignments and up 3% sequentially. Interim leadership revenue of $40 million decreased 9% from the prior year period and was down 11% from prior quarter. Search revenue declined 16% from prior year and was flat sequentially.

Locum Tenens 收入為 1.07 億美元，較上年下降 5% 或增長 11%（不包括與大流行相關的任務），環比增長 3%。中期領導收入為 4000 萬美元，比去年同期下降 9%，比上一季度下降 11%。搜索收入較上年下降 16%，環比持平。

Interim and search revenue were down prior year due to lower demand as hospitals focused on expense management. Gross margin for the Physician and Leadership Solutions segment was 35.2%, up 20 basis points both year-over-year and sequentially.

由於醫院專注於費用管理，需求下降導致去年中期和搜索收入下降。醫生和領導力解決方案部門的毛利率為 35.2%，同比和環比增長 20 個基點。

The slight margin increase year-over-year was primarily due to improved gross margins for interim and Locum tenens, partially offset by mix. Sequentially, margin growth was driven by the interim business. Segment operating margin was 15.1%, which increased 370 basis points year-over-year mainly driven by lower SG&A expenses. Sequentially, operating margin decreased 160 basis points primarily due to favorable prior quarter professional liability and other adjustments. Technology and Workforce Solutions revenue during the first quarter was $136 million, down 6% year-over-year and up 2% sequentially. Within this segment, Language Services generated revenue of $62 million, an impressive increase of 25% year-over-year and 6% quarter-over-quarter.

利潤率同比略有增長主要是由於中期和本地租賃的毛利率提高，部分被混合所抵消。因此，利潤率增長是由臨時業務推動的。分部營業利潤率為 15.1%，同比增長 370 個基點，這主要是受 SG&A 費用下降的推動。營業利潤率環比下降 160 個基點，這主要是由於上一季度有利的專業負債和其他調整。第一季度技術和勞動力解決方案收入為 1.36 億美元，同比下降 6%，環比增長 2%。在這一細分市場中，語言服務產生了 6200 萬美元的收入，同比增長 25%，環比增長 6%，令人印象深刻。

VMS revenue of $54 million decreased 28% year-over-year and 2% sequentially. Segment gross margin was 71.4% and down 530 basis points from the prior year period and down 190 basis points sequentially. The decrease in gross margin year-over-year was primarily attributable to lower VMS revenue compared with the record high from a year ago.

VMS 收入為 5400 萬美元，同比下降 28%，環比下降 2%。分部毛利率為 71.4%，較上年同期下降 530 個基點，環比下降 190 個基點。毛利率同比下降主要是由於與一年前的歷史高位相比，VMS 收入有所下降。

Sequentially, gross margin was lower, driven by a mix shift to language services. Segment operating margin in the first quarter was 49.3%, a decrease of 510 basis points year-over-year and down 90 basis points sequentially.

因此，由於向語言服務的混合轉移，毛利率較低。第一季度的部門營業利潤率為 49.3%，同比下降 510 個基點，環比下降 90 個基點。

The Consolidated first quarter adjusted EBITDA of $180 million decreased 30% year-over-year and increased 3% sequentially. Adjusted EBITDA margin of 15.9% was 70 basis points lower year-over-year and up 40 basis points sequentially.

第一季度合併調整後 EBITDA 為 1.8 億美元，同比下降 30%，環比增長 3%。調整後的 EBITDA 利潤率為 15.9%，同比下降 70 個基點，環比上升 40 個基點。

First quarter net income was $84 million, down 42% year-over-year and up 3% sequentially. First quarter GAAP diluted earnings per share was $2.02 in the quarter Adjusted earnings per share for the quarter was $2.49 compared to $3.49 in the prior year period and $2.48 in the prior quarter.

第一季度淨收入為 8400 萬美元，同比下降 42%，環比增長 3%。本季度第一季度 GAAP 稀釋後每股收益為 2.02 美元 本季度調整後每股收益為 2.49 美元，上年同期為 3.49 美元，上一季度為 2.48 美元。

Days sales outstanding was 55 days, in line with the prior quarter and 2 days lower than prior year.

未完成銷售天數為 55 天，與上一季度持平，比去年同期減少 2 天。

Operating cash flow for the first quarter was $43 million and capital expenditures were $17 million.

第一季度的運營現金流為 4300 萬美元，資本支出為 1700 萬美元。

As of March 31, we had cash and equivalents of $29 million, long-term debt of $990 million including a $140 million draw on our revolving line of credit and a net leverage ratio of 1.3:1.

截至 3 月 31 日，我們擁有 2900 萬美元的現金和等價物，9.9 億美元的長期債務，包括 1.4 億美元的循環信貸額度和 1.3:1 的淨槓桿比率。

Today, we announced that we intend to enter into a $200 million accelerated share repurchase program in the coming days. Year-to-date, we have bought back 2.4 million shares of stock for $225 million excluding brokerage fees and excise tax on share repurchase. As of today, $427 million was outstanding on the repurchase program authorized by our Board of Directors.

今天，我們宣布我們打算在未來幾天內實施一項價值 2 億美元的加速股票回購計劃。年初至今，我們以 2.25 億美元的價格回購了 240 萬股股票，其中不包括經紀費和股票回購的消費稅。截至今天，我們董事會授權的回購計劃中有 4.27 億美元未償還。

Moving to second quarter 2023 guidance. We project consolidated revenue to be in a range of $970 million to $1 billion, down 30% to 32% from the prior year period. Gross margin is projected to be 33.4% to 33.9%. Reported SG&A expenses are projected to be 19.1% to 19.6% of revenue. Operating margin is expected to be 10.6% to 11.2%, and adjusted EBITDA margin is expected to be 15.4% to 15.9%. Average diluted shares outstanding are projected to be approximately [$39 million]. Additional second quarter guidance details can be found in today's earnings release.

轉到 2023 年第二季度的指導。我們預計綜合收入將在 9.7 億美元至 10 億美元之間，比上年同期下降 30% 至 32%。毛利率預計為 33.4% 至 33.9%。報告的 SG&A 費用預計佔收入的 19.1% 至 19.6%。營業利潤率預計為 10.6% 至 11.2%，調整後的 EBITDA 利潤率預計為 15.4% 至 15.9%。平均攤薄流通股預計約為 [3900 萬美元]。更多第二季度指導細節可以在今天的收益發布中找到。

Last quarter, we talked about 2023 returning to a normal seasonal pattern after a greater than seasonal drop in second quarter revenue. The pullback in spending by hospitals intensified in recent months. The level of Travel nurse demand in March and April lead us to expect the third quarter to be our lowest revenue quarter of the year. Travel Nurse demand improved modestly in each of the past 4 weeks.

上個季度，我們談到了在第二季度收入下降幅度大於季節性之後，2023 年將恢復正常的季節性模式。近幾個月來，醫院支出的縮減加劇。 3 月和 4 月的旅行護士需求水平使我們預計第三季度將是我們今年收入最低的季度。 Travel Nurse 的需求在過去 4 週的每一周都略有改善。

We expect to finish 2023 with approximately $4 billion in revenue and an adjusted EBITDA margin of approximately 15.5%. This view assumes modest improvement in demand from current levels.

我們預計到 2023 年收入約為 40 億美元，調整後的 EBITDA 利潤率約為 15.5%。該觀點假設需求較當前水平略有改善。

And now I'd like to hand the call back to Cary.

現在我想把電話轉回卡里。

Thank you, Jeff. Before we move to Q&A, I want to recognize the great work that our health care professionals and team members are doing on the job every day. Thank you all for your dedication and your consistent excellence.

謝謝你，傑夫。在開始問答環節之前，我想表彰我們的醫療保健專業人員和團隊成員每天在工作中所做的出色工作。感謝大家的奉獻精神和始終如一的卓越表現。

I also want to give special recognition to our nurses as we celebrate National Nurses month. Recently, our Healthcare leadership solutions team, known under the AMN B.E. Smith brand was recognized by Modern Healthcare as the industry leader in executive search.

在我們慶祝全國護士月之際，我還想特別表彰我們的護士。最近，我們的醫療保健領導解決方案團隊以 AMN B.E. 聞名。史密斯品牌被現代醫療保健公認為獵頭領域的行業領導者。

Our congratulations go out to the whole leadership solutions team, which is well positioned to help clients implement their own change efforts in the fast-moving post-pandemic environment. The foundation of our company is our shared values, which are demonstrated in our second annual ESG report. For AMN, this is not in your reporting exercise. We demonstrate how responsible governance drives better health and wellness, diversity, equity, the quality and inclusion and sustainability across AMN and our communities.

我們向整個領導解決方案團隊表示祝賀，該團隊完全有能力幫助客戶在瞬息萬變的大流行後環境中實施自己的變革努力。我們公司的基礎是我們的共同價值觀，這體現在我們的第二份年度 ESG 報告中。對於 AMN，這不在您的報告工作中。我們展示了負責任的治理如何在 AMN 和我們的社區中推動更好的健康和保健、多樣性、公平、質量和包容性以及可持續性。

AMN is an industry leader in ESG performance and disclosure, and that's something we are very proud of.

AMN 是 ESG 績效和披露方面的行業領導者，這是我們引以為豪的事情。

Now operator, please open the call for questions.

現在接線員，請打開問題電話。

At this time, we will conduct the question-and-answer session. (Operator Instructions) Our first question comes from Kevin Fischbeck of Bank of America.

這時候，我們將進行問答環節。 （操作員說明）我們的第一個問題來自美國銀行的 Kevin Fischbeck。

Great. I appreciate the color on the seasonality through the rest of the year.

偉大的。在今年餘下的時間裡，我很欣賞季節性的顏色。

I guess part of the reason why you were expecting some improvement was because you felt like there was kind of a disconnect, I think, between kind of -- the orders that are coming in and the fundamental demand that the clinicians were seeing, I mean, do you still feel like the best is there? And if so, why is it persisting a little bit longer than you thought?

我想你期望有所改善的部分原因是因為你覺得有一種脫節，我認為，在某種程度上——即將到來的訂單和臨床醫生看到的基本需求之間，我的意思是，你還覺得最好的就在那裡嗎？如果是這樣，為什麼它持續的時間比你想像的要長一點？

Kevin, thanks for the question. What I would say overall, and particularly, if you look at some of the public comments the CEOs of some of the largest health care systems have said over the past 2 weeks. I think we were all going into this year knowing and frankly, we are partnering with our clients to reduce spend on a portion of their workforce that had gotten very escalated in the tail end of the pandemic in the first quarter of last year. So that was something we were doing in partnership.

凱文，謝謝你的提問。如果你看看一些最大的醫療保健系統的首席執行官在過去 2 週內發表的一些公眾評論，我總體上會說些什麼，尤其是。我認為進入今年我們都知道並且坦率地說，我們正在與我們的客戶合作，以減少他們在去年第一季度大流行病末期已經非常升級的一部分員工的支出。所以這是我們合作做的事情。

We worked through that in the last half of last year and into the first part of this year. And so we think we've made progress. I think, again, if you hear the public comments that some of those hospital executives will say as well as what we're seeing with clients.

我們在去年下半年和今年上半年完成了這項工作。所以我們認為我們取得了進展。我想，再一次，如果你聽到一些醫院高管會說的公眾評論以及我們在客戶那裡看到的評論。

We think it's going to continue to be an area of focus from a management standpoint. But we're now getting to the end of how do we really start thinking about how we build our workforce more sustainably and more holistically to grow.

從管理的角度來看，我們認為這將繼續成為關注的領域。但我們現在已經走到了盡頭，我們如何真正開始思考如何更可持續、更全面地建設我們的員工隊伍以實現增長。

And I guess we're hearing a bit more about customer churn. You mentioned, I guess, a little bit that your customers are looking for new solutions. And it sounds like you're trying to respond to that.

而且我想我們聽到了更多關於客戶流失的信息。我猜你提到了一點，你的客戶正在尋找新的解決方案。聽起來你正試圖對此做出回應。

Do you think or do you expect additional contracts, losses from this type of valuation from the customer base? Or do you see this as an opportunity to gain share from where you are? Does your guidance assume any loss or takes from that dynamic?

您是否認為或預計會因客戶群的此類估值而產生額外合同、損失？還是您認為這是一個從您所在的地方獲得份額的機會？您的指導是否會承擔任何損失或從中受益？

Yes. Let me kind of step back and talk a little bit about what we're seeing in overall market dynamics because the same dynamics reflect clients who are coming to us as potentially looking for solutions away from us. Overall, clients are really picking their heads up post pandemic and looking at how they're going to rebuild their workforce for the future. And so as I mentioned in my opening comments, in a minute ago, the focus really had been over the past year about how do we really think about cost management.

是的。讓我退後一步，談談我們在整體市場動態中看到的情況，因為同樣的動態反映了來找我們的客戶可能會從我們這裡尋找解決方案。總的來說，客戶在大流行後真正抬起頭來，研究他們將如何為未來重建員工隊伍。因此，正如我在開場評論中提到的那樣，一分鐘前，過去一年的重點實際上是我們如何真正考慮成本管理。

And getting costs -- workforce costs into a sustainable level. We're starting to see the end now of how do I really think about building a sustainable workforce for the future. And so we are seeing clients be very open to new ways to do that. And so what this means is we have probably the biggest pipeline from a depth and robustness standpoint that our team has seen of new opportunities. We've also had clients who have gone to new solutions.

並獲得成本 - 勞動力成本進入可持續水平。我們現在開始看到我如何真正考慮為未來建立一支可持續的勞動力隊伍的終結。因此，我們看到客戶對新方法持開放態度。因此，這意味著從我們的團隊看到的新機會的深度和穩健性的角度來看，我們可能擁有最大的管道。我們也有尋求新解決方案的客戶。

And so the things and the themes that clients are looking for are, they want transparency, control and sustainability.

因此，客戶正在尋找的事物和主題是，他們想要透明度、控制力和可持續性。

There's not one thing that clients are looking for in terms of the change that they want to make. It's very specific to their starting point and the type of control that they potentially want over their workforce and how they're going to build their workforce.

就他們想要做出的改變而言，沒有一件事是客戶正在尋找的。這對於他們的出發點和他們可能希望對其員工進行的控制類型以及他們將如何建立員工隊伍是非常具體的。

The biggest part of our pipeline is MSP. So we're continuing to see a tremendous amount of strength and interest in MSP programs overall.

我們管道的最大部分是 MSP。因此，我們繼續看到整體 MSP 計劃的巨大力量和興趣。

And what I'd say, when we think about the evolution of how clients are thinking, if a new client comes on to one of our platforms, typically, their incumbent could still be very involved in serving them in the future as a supplier.

我要說的是，當我們考慮客戶思維方式的演變時，如果一個新客戶進入我們的平台之一，通常情況下，他們的現任者在未來仍可能作為供應商積極參與為他們提供服務。

And the same thing would be true if we had a client where we were one of several MSPs and they were consolidating that we could still serve as a supplier or be part of the solution set.

如果我們有一個客戶，我們是幾個 MSP 之一，並且他們正在鞏固我們仍然可以作為供應商或成為解決方案集的一部分，那麼同樣的事情也會如此。

So I would say, overall, when we look at our solutions, our scale our brand reputation, our team. We feel like as clients are looking for sustainable total talent workforce solutions, that type of environment tends to favor us.

所以我想說，總的來說，當我們審視我們的解決方案時，我們會擴大我們的品牌聲譽和我們的團隊。我們覺得，當客戶正在尋找可持續的整體人才勞動力解決方案時，這種環境往往對我們有利。

Our next question comes from Trevor Romeo of William Blair. Trevor, your line is now open.

我們的下一個問題來自威廉布萊爾的特雷弗羅密歐。特雷弗，你的線路現在開通了。

First one for me is, I appreciate the commentary you just provided about Q3 kind of being the lowest revenue quarter of the year. I was wondering, based on the order activity that you're seeing today, if you could kind of parse that out into your expectations for sequential bill rate and volume trends throughout the rest of the year?

對我來說，第一個是，我很欣賞你剛剛提供的關於第三季度是今年收入最低的季度的評論。我想知道，根據您今天看到的訂單活動，您是否可以將其解析為您對今年剩餘時間的連續賬單費率和數量趨勢的預期？

Sure, Trevor. This is Jeff. So if we just take a step back, I would say that our outlook on balance for Physician Leadership Solutions and for TWS is in line with our prior view.

當然，特雷弗。這是傑夫。因此，如果我們退後一步，我會說我們對 Physician Leadership Solutions 和 TWS 的平衡展望與我們之前的觀點一致。

And then within Nurse and Allied, the nursing business followed the trend line we anticipated but the industry-wide demand ended up lower than we expected.

然後在 Nurse and Allied 中，護理業務遵循我們預期的趨勢線，但整個行業的需求最終低於我們的預期。

And so that's what now leads us to believe that Q3 will be the lowest revenue quarter of the year for the Nurse and Allied segment, approximately 10% lower than Q2, and you can think about that pretty evenly split between bill rate and volume.

因此，這就是現在讓我們相信第三季度將是護士和相關部門今年收入最低的季度，比第二季度低約 10%，你可以考慮賬單率和數量之間的平均分配。

And then we would expect, as the winter needs orders roll in into the fourth quarter time frame that we would see a sequential increase in volume in the fourth quarter within Nurse and Allied and bill rates would generally be flattish over Q3 levels.

然後我們預計，隨著冬季需求訂單進入第四季度的時間框架，我們將看到 Nurse 和 Allied 第四季度的銷量連續增長，並且票據利率通常與第三季度持平。

Okay. Great. That's really helpful. And then just for the follow-up, I had a question on kind of boomerang nurses who had left hospitals during the pandemic only to come back to permanent roles. There was an article on the news recently highlighting that dynamic.

好的。偉大的。這真的很有幫助。然後只是為了後續行動，我有一個關於在大流行期間離開醫院只是為了回到固定崗位的迴旋鏢護士的問題。最近有一篇關於新聞的文章強調了這種動態。

Just kind of curious to hear what you're seeing and hearing from your clients on that topic, given that the travel markets cooled a bit and the economic environment might be driving some nurses back to permanent work.

鑑於旅遊市場有所降溫，經濟環境可能促使一些護士重返長期工作崗位，我很想听聽您在該主題上從客戶那裡看到和聽到的內容。

Yes, Trevor, this is Landry.

是的，特雷弗，這是蘭德里。

So it's pretty hard to measure whenever the nurses are going from a travel assignment to perm, the float pool to per diem, et cetera. We of course, have seen similar reports that you've probably seen where hospital hiring is up a little bit, but the attrition numbers are still pretty high. So still a lot of churn and turnover that we're seeing.

因此，很難衡量護士何時從出差任務到燙髮，從浮池到每日津貼，等等。當然，我們已經看到類似的報告，您可能已經看到醫院招聘人數略有增加，但人員流失率仍然很高。所以我們看到的仍然有很多流失和人員流動。

Maybe I'll just touch on what we're seeing on our own supply and the interest in work in temporary contracts. So that flexibility that travel provides these professionals still very attractive to them.

也許我會談談我們在自己的供應上看到的情況以及對臨時合同工作的興趣。因此，旅行為這些專業人士提供的靈活性對他們仍然非常有吸引力。

Our new applicants in the first quarter, they were lower than Q1 of prior year, but a lot of that is because Q1 of prior year was the peak in demand and the peaking bill rates.

我們第一季度的新申請人低於去年第一季度，但這在很大程度上是因為去年第一季度是需求高峰期和賬單利率高峰期。

And then our new applicants, (inaudible) applicants, they have been flat for 4 consecutive quarters now, and they're well above our 2019 levels. In fact, they're about 2x what they were before the pandemic. So that interest is definitely there. And so there's really 2 pieces to that equation. One is the interest. They really like the flexibility of working contract.

然後是我們的新申請人，（聽不清）申請人，他們現在已經連續 4 個季度持平，並且遠高於我們 2019 年的水平。事實上，它們大約是大流行前的兩倍。所以這種興趣肯定存在。所以這個等式真的有兩部分。一是興趣。他們非常喜歡工作合同的靈活性。

And then the second thing is a lot of the investments that we've been making in our pipeline. So our mobile website, AMN Passport and all those are paying off. It's allowing clinicians to be able to find us a lot easier to be able to apply for us easier and faster. Specific to AMN Passport, it continues to be a success story for us. It is the number of users that are on the platform continues to grow. It has a really, really strong engagement.

然後第二件事是我們在管道中進行的大量投資。因此，我們的移動網站、AMN Passport 和所有這些都得到了回報。它讓臨床醫生能夠更容易地找到我們，從而能夠更輕鬆、更快速地為我們申請。具體到 AMN 護照，它對我們來說仍然是一個成功的故事。平台上的用戶數量持續增長。它具有非常非常強大的參與度。

We actually went to the App Store. You could see that it has a star rating of 4.7 out of 5.

我們實際上去了 App Store。您可以看到它的星級為 4.7（滿分 5）。

So really, really high, and it has over 15,000 reviews, which is well above any other competitive app out in the marketplace.

非常非常高，它有超過 15,000 條評論，遠遠超過市場上任何其他競爭性應用程序。

One moment for our next question. Our next question comes from Brian Tanquilut of Jefferies.

稍等一下我們的下一個問題。我們的下一個問題來自 Jefferies 的 Brian Tanquilut。

Maybe I'll follow up on the last question about Q3. As you think about the business going forward, do you think it's right to think that this is basically the bottom.

也許我會跟進關於 Q3 的最後一個問題。當您考慮未來的業務時，您是否認為這基本上是底部是正確的。

And I know you said you've seen some inflection or stabilization in the last few weeks on demand. So -- maybe just curious how you're viewing demand and bill rate trend as we look into next year?

而且我知道你說過你在過去幾週的需求中看到了一些變化或穩定。所以 - 也許只是好奇你如何看待明年的需求和賬單率趨勢？

Yes, Brian. So each of the last 4 weeks, we have seen Travel nurse demand increase slightly and we would expect that to continue through the June time period. And so as we look out into Q3 and Q4 with the $4 billion of revenue for the full year, that would imply roughly just under $1.9 billion in the back half at just above 15% adjusted EBITDA margins. And we do think annualizing that back half is a good base to think about the business into '24 and beyond.

是的，布萊恩。因此，過去 4 週的每一周，我們都看到旅行護士的需求略有增加，我們預計這種情況將持續到 6 月份。因此，當我們展望第三季度和第四季度的全年收入為 40 億美元時，這意味著後半年大約略低於 19 億美元，調整後的 EBITDA 利潤率略高於 15%。而且我們確實認為將後半年化是一個很好的基礎來考慮進入 24 歲及以後的業務。

Okay. That makes sense. And then maybe shifting gears a little bit. The Locums business and the Allied side of the business, I mean, anything we should be thinking about in terms of -- were, first, what you're seeing and then maybe any factors that could drive some acceleration in growth in demand for those non-nursing for the Locums business?

好的。這就說得通了。然後可能會換檔一點。 Locums 業務和 Allied 方面的業務，我的意思是，我們應該考慮的任何事情 - 首先是您所看到的，然後可能是任何可能推動這些需求加速增長的因素Locums 業務的非護理？

Thank you, Brian, for the question. This is James, and we'll speak to the locum side of the marketplace. Locums is a good news story for us. You look at their demand is still 50% higher than 2019 in pre-COVID levels. You think about our business, our business revenue growth is high single digits year-over-year. Our fuel rates are up quarter-over-quarter. Our book spreads are up quarter-over-quarter and also year-over-year.

布賴恩，謝謝你提出這個問題。我是 James，我們將與市場的本地人交談。 Locums 對我們來說是個好消息。你看看他們的需求在 COVID 之前的水平上仍然比 2019 年高出 50%。你想想我們的業務，我們的業務收入同比增長是高個位數。我們的燃油費率環比上漲。我們的賬面價差環比上升，同比上升。

From a Q2 standpoint, we still think that we expect to have very solid growth going into the next quarter and also more profitable growth with inside of the Locums marketplace.

從第二季度的角度來看，我們仍然認為我們預計下一季度將實現非常穩健的增長，並且在 Locums 市場內部實現更有利可圖的增長。

The thing that we're looking at is we're very laser-focused on the demand that's out there, but we want to be profitable, have profitable growth, not just any growth. So we're laser-focused on that, and you're able to see that in some of the results that Jeff read out earlier.

我們正在關注的是我們非常專注於那裡的需求，但我們希望盈利，有盈利增長，而不僅僅是任何增長。所以我們非常專注於此，您可以在 Jeff 之前讀出的一些結果中看到這一點。

Brian, it's Landry. I'll hit on Allied. So I guess, first off, on the demand, demand in Allied is really strong. It's more than double what it was before the pandemic. So we're really excited about that. There is a little bit of a mix change in there where, I'd say, a slight headwind on volume because you've got the specialties that are tied more towards COVID that are coming down and kind of hurting the year-over-year comp a little bit. So those would be things like phlebotomy, respiratory therapists and med techs.

布賴恩，是蘭德里。我會打盟軍。所以我想，首先，在需求方面，盟軍的需求非常強勁。這是大流行之前的兩倍多。所以我們對此感到非常興奮。那裡有一些混合變化，我想說的是，數量上有輕微的逆風，因為你有更多與 COVID 相關的專業，這些專業正在下降，並且有點傷害年復一年comp一點。因此，這些將是諸如放血、呼吸治療師和醫療技術人員之類的事情。

But then it's all offset by this really good strength that's tied to therapy, which is usually PT/OT and Speech, as well as imaging.

但是，這一切都被與治療相關的真正強大的力量所抵消，通常是 PT/OT 和語音，以及成像。

So really excited about the demand. The team is performing really well up against that demand, certainly an area that looks good as we progress through the rest of the year. And then I won't go into detail unless there's another question on it, but I would also call out our international businesses are performing really well as well as our schools business.

對需求感到非常興奮。該團隊在滿足這一需求方面表現非常出色，隨著我們在今年餘下時間的進展，這當然是一個看起來不錯的領域。除非還有其他問題，否則我不會詳細介紹，但我還要指出，我們的國際業務和我們的學校業務一樣表現得非常好。

And the overall comment that I would make, which I think your question really highlights is one of the core positioning for us with our clients is how we help them holistically across all of their clinician needs. And I think when you hear the comments that both James and Landry talked about, I think it's very reflective of the strong partnerships that we've built with them and really being able to help them serve their patients and continue to grow their businesses and their organizations.

我要發表的總體評論，我認為你的問題真正強調的是我們與客戶的核心定位之一是我們如何全面幫助他們滿足他們所有的臨床醫生需求。我想當你聽到 James 和 Landry 談到的評論時，我認為這很好地反映了我們與他們建立的牢固的合作夥伴關係，真正能夠幫助他們為他們的病人服務並繼續發展他們的業務和他們的組織。

One moment for our next question. Our next question comes from Jeffrey Silber of BMO Capital Markets.

稍等一下我們的下一個問題。我們的下一個問題來自 BMO Capital Markets 的 Jeffrey Silber。

You spoke earlier in terms of working with your clients to help them manage their own costs. I'm just wondering if you can give us a little bit more color on what you're doing internally to manage your own cost in this environment of declining revenues to try to keep your margins above that 15% level.

您之前談到與客戶合作以幫助他們管理自己的成本。我只是想知道你是否可以給我們更多關於你在內部所做的事情的顏色，以在收入下降的環境中管理你自己的成本，試圖將你的利潤率保持在 15% 的水平以上。

Yes. Let me take that one first. For all of you who have been with us throughout the years, you have witnessed firsthand, that AMN has always adapted well as market conditions fluctuate, whether that is flexing up to demand or flexing down to demand. And it really is a core value proposition to our clients because we are there to help them in times of need and be able to meet their needs quickly and seamlessly.

是的。讓我先拿那個。對於多年來一直與我們在一起的所有人，您親眼目睹了 AMN 始終能夠適應市場條件的波動，無論是根據需求靈活調整還是根據需求靈活調整。這確實是我們客戶的核心價值主張，因為我們會在他們需要的時候幫助他們，並能夠快速、無縫地滿足他們的需求。

So if you look at our ability to do that particularly even in this quarter, while our revenues went down 27% year-over-year, our adjusted SG&A is down 20% year-over-year. And the majority of that expense reduction has not impacted headcount. So the things that we are doing. One is we have active experience planning. So we went into this year knowing that we were working with our clients to reduce key elements of their workforce spend and plans for that.

因此，如果你看看我們這樣做的能力，尤其是在本季度，雖然我們的收入同比下降了 27%，但我們調整後的 SG&A 同比下降了 20%。而且大部分費用減少並沒有影響員工人數。所以我們正在做的事情。一是我們有積極的體驗規劃。因此，進入今年以來，我們知道我們正在與客戶合作，以減少他們勞動力支出的關鍵要素並為此制定計劃。

We are always doing continuous performance management attrition as the primary drivers of how we continue to manage those costs.

我們一直在進行持續的績效管理，將減員作為我們如何繼續管理這些成本的主要驅動力。

Okay. That's really helpful. Appreciate that. Jeff, I think you had mentioned that you -- I don't know if you used the word goals, but for 2023, the revenue and adjusted EBITDA numbers that you gave us assumes some modest demand improvement. What would those numbers be if there's no demand improvement?

好的。這真的很有幫助。感謝。傑夫，我想你提到過你——我不知道你是否使用了目標這個詞，但對於 2023 年，你給我們的收入和調整後的 EBITDA 數字假設需求有所改善。如果沒有需求改善，這些數字會是多少？

Yes, I would say it's in the low single digit range, Jeff, is what the improvement is into Q3 and Q4 in the demand environment.

是的，傑夫，我會說它處於低個位數範圍內，這就是需求環境中第三季度和第四季度的改進。

And again, our viewpoint on bill rates is that they'll be down high single digits in the second quarter, down mid-single digits in the third quarter, and that's informed on the visibility we have into Q3 right now. As well as the open orders that we're recruiting for and then flat sequentially into Q4.

同樣，我們對票據利率的看法是，它們將在第二季度下降到高個位數，在第三季度下降到中等個位數，這反映了我們現在對第三季度的可見性。以及我們正在招募的未結訂單，然後依次持平到第四季度。

So there's -- that's the bill rate side of the equation, and it's not a huge lift on the volume side from what we're seeing right now. It's, again, in that low single-digit range.

所以 - 這是等式的票據利率方面，與我們現在看到的相比，它在數量方面並沒有太大的提升。它再次處於那個低的個位數範圍內。

So the demand improvement is mostly coming in the fourth quarter, that's what you're saying?

所以需求改善主要出現在第四季度，這就是你的意思？

Sequentially over Q3, yes, because Q2, we do expect Q3 will be down mid-single digits for Q2.

在第三季度，是的，因為第二季度，我們確實預計第三季度將下降到第二季度的中個位數。

Our next question comes from Tobey Sommer of Truist Securities. Tobey, your line is now open.

我們的下一個問題來自 Truist Securities 的 Tobey Sommer。 Tobey，您的線路現已開通。

As the business and demand trends stabilize, I'm curious if demand picks up, do you think you'll be able to grow your Travel nurse business above and beyond seasonality at current pricing trends.

隨著業務和需求趨勢的穩定，我很好奇需求是否回升，您認為您的旅行護士業務能否在當前定價趨勢下超越季節性增長。

Or would it require bill rates out in the market to increase to more in some additional supply to generate growth?

或者它會要求市場上的票據利率在一些額外的供應中增加到更多以產生增長嗎？

So if you step back and think a little bit about what we typically see from a volume standpoint, as volumes go up, you tend to see bill rates and pay rates have to go up to be able to attract that. I think what we've seen and maybe the balancing piece of that, that we have witnessed over the past couple of quarters is you've actually seen stabilization really since the high point of Q1 2022.

因此，如果你退後一步，從數量的角度考慮一下我們通常看到的情況，隨著數量的增加，你往往會看到賬單利率和支付利率必須上升才能吸引它。我認為我們在過去幾個季度所看到的，也許是其中的平衡部分是，自 2022 年第一季度的高點以來，你實際上已經看到了穩定。

So I would say at this point, we're not assuming that you're going to see a substantial increase in bill rates. And we still think that the balance between bill rates and volume could still be fine if you had a slight increase in volume towards the end of the year.

所以我想說，在這一點上，我們並不是假設你會看到賬單利率大幅上漲。而且我們仍然認為，如果您在年底前的交易量略有增加，票據利率和交易量之間的平衡可能仍然很好。

Okay. Could you talk to us about a two sort of detailed questions. How is your spend under management from an MSP perspective and churn within the book of business? And maybe could you contextualize winter orders sort of size that and influence and how much higher price that is than the average?

好的。你能和我們談談兩類詳細的問題嗎？從 MSP 的角度來看，您的支出是如何管理的，以及在業務簿中的流失情況？也許你能將冬季訂單的規模和影響以及比平均價格高多少的背景聯繫起來嗎？

Let me give some overall context about MSP, and then I'll have Landry talk a little bit about the winter orders. As you have seen, as we talked about just the significance of our MSP programs in terms of spend. And I'd say this was particularly true during COVID, where we made a very intentional and strategic priority to focus our limited supply on our MSP clients.

讓我給出一些關於 MSP 的總體背景，然後我會讓蘭德里談談冬季訂單。正如您所見，正如我們所討論的，我們的 MSP 計劃在支出方面的重要性。我要說的是，在 COVID 期間尤其如此，我們有意將有限的供應重點放在我們的 MSP 客戶身上。

Our MSP spend tends to track what you see overall in our Nurse and Allied business because that is the biggest program under our MSPs. So when you go through and as we talk about some of what we're seeing overall in the Nurse and Allied business, that tends to align well with what we're seeing overall in our MSP.

我們的 MSP 支出傾向於跟踪您在我們的護士和相關業務中看到的整體情況，因為這是我們 MSP 下最大的項目。因此，當你經歷並且當我們談論我們在護士和聯合業務中看到的一些整體情況時，這往往與我們在 MSP 中看到的整體情況保持一致。

Now as we've come out of the pandemic, we have been able to provide more support than we did during the pandemic to some of our VMS programs. And so you're seeing that alignment still stay correlated, but it's not quite as one for one as you may have seen during the pandemic.

現在我們已經走出大流行，我們能夠為我們的一些 VMS 項目提供比大流行期間更多的支持。所以你會看到這種一致性仍然保持相關，但它並不像你在大流行期間看到的那樣一對一。

Tobey, I'll hit on the winter orders real quick. This is Landry. So our definition of winter orders whenever a client is giving us bulk orders kind of in the June to July time frame. For orders or start dates that typically start either at the latter end of Q3 or throughout Q4. So that's kind of the way that we label our winter orders.

托比，我很快就會收到冬季訂單。這是蘭德里。因此，只要客戶在 6 月至 7 月的時間範圍內向我們提供批量訂單，我們就會定義冬季訂單。對於通常在第三季度末或整個第四季度開始的訂單或開始日期。這就是我們標記冬季訂單的方式。

The last couple of years, it's been hard for some of those accounts to plan for that, just with the different fluctuations that were going on in the market. We are anticipating winter needs this year. And you asked about the bill rates on them.

在過去的幾年裡，其中一些賬戶很難為此做出計劃，只是市場上發生了不同的波動。我們預計今年的冬季需求。你問了他們的賬單費率。

I'd say the biggest reason for the bill rate increase is that we see higher utilization in our clients that drive higher rates. So it's a lot of it is more of a geographic phenomenon that it is, customers truly paying a higher rate for that time of the year.

我想說票據利率上漲的最大原因是我們看到客戶的更高利用率推動了更高的利率。所以這在很大程度上更像是一種地理現象，客戶在一年中的那個時候確實支付了更高的費用。

One moment for our next question. Our next question comes from A.J. Rice of Credit Suisse.

稍等一下我們的下一個問題。我們的下一個問題來自 A.J.瑞士信貸大米。

First of all, just to make sure because sometimes we're big headed here. Jeff, just to take your point. So before you were looking for $4.2 billion to $4.3 billion in revenue this year, now you're thinking $4 billion. The EBITDA margin was previously you talked about as being 15% to 15.5%.

首先，只是為了確定，因為有時我們在這裡很大膽。傑夫，只是為了說明你的觀點。因此，在您今年尋求 42 億至 43 億美元的收入之前，現在您正在考慮 40 億美元。您之前談到的 EBITDA 利潤率為 15% 至 15.5%。

Now you're talking about being at the high end of that 15.5%. And if I do the math right, at the midpoint, you were at $650 million before and now you're taking $620 million of EBITDA.

現在你談論的是處於 15.5% 的高端。如果我算對了，在中點，你之前是 6.5 億美元，現在你的 EBITDA 是 6.2 億美元。

So $30 million adjustment on a full year basis with first quarter being a little higher third quarter being a little lower admittedly. Is -- and would you say that is all based on somewhat of a change in view of where you shake out on Allied and travel nursing. Is there any other change you're making to your outlook of significance?

因此，全年調整 3000 萬美元，第一季度略高，第三季度略低。是——你會說這完全是基於你在 Allied 和旅行護理方面的變化。您對重要性的看法還有其他改變嗎？

Yes, A.J., so I would agree with your numbers. I would say it's really a travel nurse change predominantly. Obviously, with some of the demand trends that we talked about on the nursing side, that is impacting our VMS business as well. But that's largely offset by strength within Language Services.

是的，A.J.，所以我同意你的數字。我會說這主要是旅行護士的變化。顯然，我們在護理方面談到的一些需求趨勢也影響了我們的 VMS 業務。但這在很大程度上被語言服務部門的實力所抵消。

So Language Services was up 25% year-over-year in the first quarter. So any hit to the VMS businesses largely being offset by language services within TWS, and the change is really coming within travel nurse.

因此，語言服務在第一季度同比增長 25%。因此，對 VMS 業務的任何打擊在很大程度上都被 TWS 內的語言服務所抵消，而這種變化確實發生在旅行護士內部。

Okay. And then when you think about supply demand of getting nurses who are willing to step up for assignments? You talked about if volume improves, you might have to see a little rate improvement to get that volume. What about this concept of at some point, you hit a breakpoint where it's going to be really hard to get nurses in dramatically pull back. As you're looking at where you think rates would bottom in the third quarter. Are you pretty close to that number where you'd see a meaningful percentage of the people that are willing to take travel assumes today might back off so that, that gives you a second way to consider where a floor might be? Or do you still think there's some leeway there?

好的。然後，當您考慮讓願意承擔任務的護士的供應需求時？您談到如果音量有所提高，您可能必須看到速率略有提高才能獲得該音量。關於這個概念，在某個時候，你遇到了一個斷點，很難讓護士大幅撤回。正如你所看到的那樣，你認為利率將在第三季度觸底。您是否非常接近那個數字，您會看到有相當比例的願意旅行的人假設今天可能會退縮，這樣您就可以通過第二種方式來考慮底線在哪裡？或者你仍然認為那裡有一些迴旋餘地？

Hey A.J., it's Landry. I mean I think probably the biggest thing that I would say to that is, right now, what we're experiencing within travel nurses, it's not a supply issue for travel, it's a demand issue. The interest is there, right? There's not -- there's certainly not enough nurses to go around to fill all of the permanent and temporary and per diem needs throughout in the marketplace.

嘿 A.J.，我是蘭德里。我的意思是，我想我想說的最重要的事情可能是，現在，我們在旅行護士中遇到的問題，這不是旅行的供應問題，而是需求問題。興趣在那裡，對吧？沒有——肯定沒有足夠的護士四處走動來滿足市場上所有的永久性和臨時性以及每日津貼需求。

But the desire to work travel is there. So that hasn't been an issue. On the paid piece of it, it is economics on supply-demand. So we've factored all that into where we believe the demand is going to be and where we think pay needs to be, and we're having those conversations with our customers.

但工作旅行的願望是存在的。所以這不是問題。在付費部分，它是供需經濟學。因此，我們將所有這些因素都考慮到了我們認為需求將會出現的地方以及我們認為需要支付的地方，並且我們正在與我們的客戶進行這些對話。

But still pay is only one factor when the clinicians are making their decision to travel. Actually, location is the #1 preference that goes over everything when they're making decisions to work contracts. So it's things like location, pay does rank in the top 4, but the other things that rank really high is flexibility and working conditions. So right now today, we're not seeing a supply issue. If we can get the demand of pump head curve, we'll be able to capture.

但是，當臨床醫生決定出差時，薪酬仍然只是考慮因素之一。實際上，在他們決定是否簽訂工作合同時，地點是凌駕於一切之上的第一偏好。因此，位置、薪酬確實排在前 4 位，但其他排名真正靠前的是靈活性和工作條件。所以今天，我們沒有看到供應問題。如果我們能得到泵揚程曲線的需求，我們就能捕獲。

And I would underscore with that, we just released our nurses survey on Monday. And I think all the points that Landry put in there underscored it. So we're still seeing a huge interest in as much as anything, it's a lifestyle choice.

我要強調的是，我們剛剛在周一發布了我們的護士調查。我認為 Landry 提出的所有觀點都強調了這一點。所以我們仍然看到人們對任何東西都非常感興趣，這是一種生活方式的選擇。

Interesting. One final last question on -- you mentioned in the prepared remarks, interest in M&A, willingness to do M&A.

有趣的。最後一個問題 - 你在準備好的評論中提到，對併購的興趣，進行併購的意願。

I know the company has talked about it before, but obviously, Cary, you've had a little time to be there. Does that broaden in any way what you guys might look at now that you've gotten to understand the organization, the competitive landscape out there? Or what's the latest thinking on where you might look for deals?

我知道公司之前已經談過這個問題，但很明顯，卡里，你有一點時間在那裡。既然你們已經了解了組織和那裡的競爭格局，這是否會以任何方式擴大你們的視野？或者關於您可能在哪裡尋找交易的最新想法是什麼？

Yes. Overall, very consistent thinking with some of my comments last quarter. I'll start first with -- we are always interested in looking at M&A as a way to accelerate our growth in key areas. And so that remains true. I think what we saw for some time period, and this is a general comment across a number of industries, as you saw a relatively slow M&A environment as there was broader market volatility we would expect that you would see that start to stabilize a bit as we go through the year.

是的。總體而言，與我上個季度的一些評論的想法非常一致。我首先要開始——我們總是有興趣將併購視為加速我們在關鍵領域增長的一種方式。所以這仍然是真的。我認為我們在一段時間內看到的情況，這是對許多行業的普遍評論，因為你看到併購環境相對緩慢，因為市場波動更大，我們預計你會看到這種情況開始穩定下來我們度過了這一年。

And we're interested in opportunities that we think are going to provide better solutions for our clients, more tech enablement, really strong growth opportunities, particularly in specialized areas where we see continued demand.

我們對我們認為將為我們的客戶提供更好的解決方案、更多的技術支持、真正強勁的增長機會的機會感興趣，特別是在我們看到持續需求的專業領域。

One moment for our next question. Our next question is going to be coming from Bill Sutherland of The Benchmark company. (inaudible) Our next question is going to be coming from Andre Childress of Baird. Your line is now open.

稍等一下我們的下一個問題。我們的下一個問題將來自 The Benchmark 公司的 Bill Sutherland。 （聽不清）我們的下一個問題將來自 Baird 的 Andre Childress。您的線路現已開通。

This is Andre on for Mark Marcon. So my first question, just want to follow up on some previous comments you had on the expectations you laid out. Where do you now expect build rates and volumes to exit the year compared to pre-pandemic levels?

這是 Andre 為 Mark Marcon 做的。所以我的第一個問題，只想跟進您之前對您提出的期望發表的一些評論。與大流行前的水平相比，您現在預計今年的建造速度和產量將達到什麼水平？

Yes. On the bill rate side, we would still expect them to be 30% to 35% above pre-pandemic, Andre, and that's roughly 30% lower than they were in the peak of the first quarter of last year.

是的。在票據利率方面，我們仍然預計它們將比大流行前高出 30% 至 35%，安德烈，這比去年第一季度的峰值低了大約 30%。

Yes. On the volume side, it would be in the 20% to 25% range above pre-pandemic.

是的。在數量方面，它將比大流行前高出 20% 至 25%。

Okay. Great. And then the language services business continues to see a lot of really great strength. How do you view the opportunities in that space? And how large could that business ultimately become?

好的。偉大的。然後語言服務業務繼續看到很多非常強大的力量。您如何看待該領域的機會？該企業最終能發展到多大？

Let me take it from a general standpoint. So we really love that business for a number of reasons. One is if you look at the biggest macro trends. One in 5 patients coming in are not going to speak English as their primary language. And so that demographic is incredibly compelling. The other piece of it is when you look at how you really create optimized workforces in health systems. They have a very strong desire to be patient-centric, and a part of that is language services.

讓我從一般的角度來看。因此，出於多種原因，我們真的很喜歡這項業務。一個是如果你看看最大的宏觀趨勢。五分之一的患者不會以英語為主要語言。因此，人口統計非常引人注目。另一部分是當您查看如何真正在衛生系統中創建優化的勞動力時。他們強烈希望以患者為中心，其中一部分是語言服務。

This gives them an ability to do that literally across hundreds of languages in a very cost-effective way without having to schedule multiple language clinicians during some of those shifts. So we love it for an overall match against macro demographics as well as how we can serve our clients and patients well. And obviously, culturally, we have a huge diversity and inclusion focus, which that also aligns very nicely too.

這使他們能夠以非常經濟高效的方式在數百種語言中做到這一點，而不必在其中一些輪班期間安排多位語言臨床醫生。因此，我們喜歡它與宏觀人口統計數據的整體匹配以及我們如何為我們的客戶和患者提供良好服務。顯然，在文化上，我們非常注重多樣性和包容性，這也非常吻合。

If you look at the overall growth that they have seen, we expect for that business to continue to grow. Right now, we see -- we still continue to see demand in interest in that space. And a big area of focus for us there is how we continue to build out and scale the business, particularly among different languages to be able to meet that demand.

如果你看看他們看到的整體增長，我們預計該業務將繼續增長。現在，我們看到 - 我們仍然繼續看到對該領域感興趣的需求。我們關注的一個大領域是我們如何繼續建立和擴展業務，特別是在不同語言之間，以滿足這一需求。

I guess transitioning over to some capital allocation and strategy questions. I guess the first quick one will be, could you provide some more details on the accelerated buyback program, particularly on the timing?

我想過渡到一些資本配置和戰略問題。我想第一個問題是，您能否提供有關加速回購計劃的更多詳細信息，尤其是時間安排？

Yes. So we plan to enter into that in the coming days. Andre, and the size of that would be $200 million. But we would -- it will be a second quarter event and then completed over a number of months, but at the outside by the midpoint of the fourth quarter.

是的。因此，我們計劃在未來幾天內進行討論。安德烈，其規模將達到 2 億美元。但我們會 - 這將是第二季度的活動，然後在幾個月內完成，但在第四季度中點的外部。

Great. And Cary, you spoke about some of the leadership changes, some of the initiatives to accelerate the businesses.

偉大的。卡里，你談到了一些領導層的變化，一些加速業務發展的舉措。

Could you provide a little bit more color on some of those initiatives? And what are you most excited about?

您能否為其中一些舉措提供更多色彩？你最興奮的是什麼？

Yes. So I celebrated my 5-month anniversary at AMN this week.

是的。所以這週我在 AMN 慶祝了我的 5 個月週年紀念日。

And what I committed to all of you when I joined was that I was going to spend and very quickly get [extense] of the market, talking to our clients, our clinicians, all of you and really better understanding what AMN's opportunities were as we enter this next chapter of growth. The announcements that I made today are really intended to emphasize our focus around 3 areas that I think are going to be critical for us in the coming years.

當我加入時，我向你們所有人承諾的是，我將投入並很快獲得[廣泛的]市場，與我們的客戶、我們的臨床醫生、你們所有人交談，真正更好地了解 AMN 的機會是什麼，因為我們進入增長的下一章。我今天發布的公告實際上是為了強調我們對我認為在未來幾年對我們至關重要的 3 個領域的關注。

One is it is incredibly clear that clients focus is really around how do I build a sustainable workforce. There is increased utilization demand. There is -- into the intermediate term, you could argue into the long-term constraints on clinician supply. And they're looking for partners who are going to help them be able to very broadly think about different levers and different ways that they can create sustainability, broadly speaking, in their workforces. That is a huge priority as we think about some of the changes that we made.

一是非常清楚，客戶關注的重點實際上是我如何建立可持續的員工隊伍。使用需求增加。有 - 進入中期，你可以爭論對臨床醫生供應的長期限制。他們正在尋找能夠幫助他們更廣泛地思考不同的槓桿和不同的方式來創造可持續性的合作夥伴，從廣義上講，他們的員工隊伍。當我們考慮我們所做的一些更改時，這是一個非常重要的優先事項。

One -- the other one is we want to grow our business as 1 AMN. I talked about this in the last call where we have a broad range of over 20 solutions.

一個 - 另一個是我們希望將我們的業務發展為 1 AMN。我在上次電話會議中談到了這一點，我們有 20 多種解決方案。

We do a very good job of talking to clients about them. We haven't done as good of a job of seamlessly integrating them for the benefit of our clients, which will be an area of focus for us. And the last piece is we really want to position and highlight our tech-enabled solutions. And so one of the detriments of having strong MSP programs is under an MSP, many times, our clients don't see our technology that we have underneath it. We have phenomenal technology that we have continued to invest in and we want to make sure that we are highlighting across the board, all of our tech-enabled solutions.

我們在與客戶談論他們方面做得很好。為了我們客戶的利益，我們還沒有做好無縫整合它們的工作，這將是我們關注的一個領域。最後一點是我們真的想定位和突出我們的技術解決方案。因此，擁有強大的 MSP 計劃的不利因素之一是在 MSP 下，很多時候，我們的客戶看不到我們在其下擁有的技術。我們擁有我們持續投資的非凡技術，我們希望確保我們全面強調我們所有的技術支持解決方案。

So we had these 3 imperatives as we are making the changes. And so if you look at the realignment that I did, we have a focus with a Chief Revenue Officer, and we have an outstanding leader in Pat McCall, who came into that role. We have a dedicated Chief Business Officer, where we are going to focus not just on our own AMN corporate growth strategy, but importantly, helping our clients be able to develop a sustainable workforce.

因此，在進行更改時，我們有這 3 個當務之急。因此，如果你看看我所做的調整，我們的重點是首席營收官，我們有一位傑出的領導者 Pat McCall，他擔任了這個角色。我們有一位專職的首席商務官，我們將不僅專注於我們自己的 AMN 企業發展戰略，更重要的是，幫助我們的客戶能夠培養可持續的員工隊伍。

Meredith Lapointe coming over from really helping build the Healthcare McKinsey practice at McKinsey over the past 16 years, but also her focus on sustainable workforce, we think is going to really accelerate our game in that area.

Meredith Lapointe 在過去 16 年中真正幫助麥肯錫建立了麥肯錫醫療保健實踐，而且她對可持續勞動力的關注，我們認為這將真正加速我們在該領域的發展。

And then finally, having Nishan, who has been our Chief Strategy and Marketing Officer and responsible for our M&A go over and lead in a dedicated way our technology workforce solutions, is going to accelerate growth in all those areas. So we have strong leadership alignment around key areas of focus for us.

最後，讓一直擔任我們的首席戰略和營銷官並負責我們的併購的 Nishan 以專門的方式領導我們的技術勞動力解決方案，將加速所有這些領域的增長。因此，我們在我們關注的關鍵領域擁有強大的領導力。

And we are doing the same internally around how we continue to prioritize our one AMN initiative.

我們正在圍繞如何繼續優先考慮我們的一項 AMN 計劃在內部做同樣的事情。

I would now like to turn it back to Cary Grace, Chief Executive Officer.

我現在想把它轉回首席執行官 Cary Grace。

Thank you all for joining us in this call. and thank you for your continued interest in AMN. We look forward to talking to you over the coming weeks and months.

感謝大家加入我們的電話會議。並感謝您對 AMN 的持續關注。我們期待在接下來的幾周和幾個月內與您交談。

Thank you for your participation in today's conference. This does conclude the program. You may now disconnect.

感謝您參加今天的會議。這確實結束了程序。您現在可以斷開連接。